Nutritional Assessment And A Study On The Timing Of Enteral Nutrition After Operation In The Patients With Malignant Obstructive Jaundice

Malnutrition is one of the important factors which increase the postoperative complications and death rate in the patients with obstructive jaundice.The peri-operative nutritional intervention may improve the nutritional condition effectively and reduce the prevalence of postoperative complications.Now there are few studies on the nutritional status and the tool of nutritional assessment in the patients with malignant obstructive jaundice and it is not clear about the timing of enteral nutrition in postoperative patients with such disease.The study includes two parts,which are the nutritional assessment and the study on the timing of enteral nutrition in postoperative patients with malignant obstructive jaundice.1,Nutritional assessment of patients with malignant obstructive jaundiceObjective To explore the effect of the mini-nutritional assessment(MNA) for evaluating nutritional status and assess the prevalence of malnutrition in the patients with malignant obstructive jaundice.Methods The nutritional status of one hundred patients admitted to hospital with malignant obstructive jaundice was measured by mini-nutritional assessment(MNA),and their anthropometric markers and nutritional biochemistry markers were also collected.Then the correlation between MNA and anthropometric markers and that between MNA and nutritional biochemistry markers were investigated.Results According to the scores of MNA,the prevalence of malnutrition was 7%and that of risk of malnutrition was 54%.There were significant differences in anthropometric markers and nutritional biochemical markers among patients who were malnourished,at risk of malnutrition or in adequate nutritional status.MNA score correlated with anthropometric markers and nutritional biochemical markers(r=0.212～0.553,P＜0.05).Conclusions The prevalence of malnutrition and the risk of malnutrition is 76%in patients with malignant obstructive jaundice.So the proper nutritional intervention should be given to the patients when admitted to the hospital according to the results of nutritional assessment.MNA score correlates with anthropometric markers and nutritional biochemical markers,so it is effective for nutritional assessment in such patients. 2,A study on the timing of enteral nutrition in postoperative patients with malignant obstructive jaundiceObjective To explore the appropriate timing of enteral nutrition in postoperative patients with malignant obstructive jaundice.Methods Sixty postoperative patients with malignant obstructive jaundice were randomized into early enteral nutrition group(enteral nutrition was given in 24h after surgery) and delayed enteral nutrition group(enteral nutrition was given after anus exhaust).The postoperative nutritional condition,incidence of gastrointestinal adverse reactions and complications of operation,time of anus exhaust,and nutritional cost were compared between the two groups.Results There was no statistical difference in postoperative nutritional condition,incidence of gastrointestinal adverse reactions and complications of operation between the two groups(P＞0.05);The anus exhaust in the early enteral nutrition group was earlier than that in the delayed enteral nutrition group,and the nutritional cost was less than that in the delayed enteral nutrition group(P＜0.05).Conclusions Enteral nutrition given in 24h in postoperative patients with malignant obstructive jaundice is safe,and it can promote the recovery of gastrointestinal function and decrease the nutritional cost.